Relationship between the home environment’s risk for child obesity and family well being among rural low income families

4/6/2012Relationship between the home environment’s risk for child obesity and family well-being among rural low income families Kimberly Greder, Associate Professor and Extension Specialist, Human Development & Family Studies Michelle Ihmels, Assistant Adjunct Professor, Kinesiology Flor Romero de Slowing, Interdisciplinary Graduate Studies Iowa State University Janie Burney, Professor and Extension Nutrition Specialist University of Tennessee Knoxville• Child obesity - tripled since 1980.• 1 of 7 low-income, preschool children is obese.• 17% of children 2—19 years are obese.• Hispanic boys more likely to be obese than white boys• Black girls more likely to be obese than white girls. 1

4/6/2012What makes up the home environment?What factors in the home environmentdoes research suggest are associated withrisk for child obesity?Social• Parental role modeling, parenting policies and strategies (including feeding practices) related to physical activity, food and media behaviorsPhysical• Availability and accessibility of food, physical activity and media 2

4/6/2012Parent well-being and parent/childattachment linked to child obesityPoor child health and obesity linked to ...• Maternal depression• Poor quality maternal/child relationshipRural people more likely to be inactive and poor Poverty related to Child Obesity252015 Child Obesity1050 < 100% FPL 200-399% FPL > 500% FPL 3

4/6/2012Why is it important tounderstand the link betweenthe home environment andchild obesity? Conference theme: Partnerships to Improve the Health of the Nation 4

4/6/2012Wave 1- 382 families http://ruralfamiliesspeak.org/ Race/ethnicity white Latino Black Native American Asian/Pacific Islander 5

4/6/2012 Marital Status Single/never married Divorced/widowed Married Living with partner• Avg age of mother = 32years• Avg. annual household income = $15,000 - 19,000• 2/3 of the mothers did not work outside home for pay• 68% participated in SNAP• 51% participated in WIC• 66% participated in Free/Reduced Priced Meals Mother Body Mass Index Underweight Normal weight Overweight Obese 6

4/6/2012 Measures1. Family Nutrition and Physical Activity (FNPA) screening tool – 21 items- assess home environments that may predispose children to becoming overweight2. Family Rituals and Daily Routines - 26 items3. Center for Epidemiologic Studies Short Depression Scale (CES-D 10) - identifies depressive symptomology4. Financial Distress – 7 itemsResearch questions1. What is the relationship between mothers’ FNPA score and family and mother variables?2. Does race/ethnicity mediate the relationship between mothers’ FNPA score and family and mother variables? 7

4/6/2012 What we learned…. The higher the FNPA score, the higher family routines score and lower the maternal depression and financial stress scores. Family Rituals and Daily CES-D Depression Scale Financial Distress/ Routines Scale Financial Well-being Scale FNPA Pearson Correlation 0.226** -.205** -.118* Sig. (2 tailed) 0.00 0.00 .024 N 295 361 361What we learned…. FNPA Family Rituals and Daily CES-D Depression Financial Distress/ Financial Well- Routines Scale ScaleA higher FNPA score for… being Scale Latinas• Latinas was associated with a Pearson higher family routine score Correlation Sig. (2 tailed) 0.239* .011• whites was associated with a N White 112 higher family routine score, lower Pearson maternal depression and lower Correlation Sig. (2 tailed) .237** .004 -.275** .000 -.144 .050 financial stress N 147 186 186 American Indians• American Indians was associated Pearson with a higher family routine score Correlation Sig. (2 tailed) .799** .010 -.698** .006 and lower maternal depression N 9 14 Asian• Asians was associated with lower Pearson maternal depression Correlation Sig. (2 tailed) -.832** .005 N 9 8

4/6/2012What does this mean?Families that have a health enhancing homeenvironment are also more likely to have…• daily family routines and practice religious or cultural based rituals• mothers who are less likely to be depressed• less perceived financial stress• How can you apply these findings to your work with rural, low-income families that have young children?• What are you currently doing that you should continue to do?• What could you do differently?• What additional research is needed? 9

4/6/2012Consider the complexity of factors facing somerural low income families that shape eating andactivity behaviors.• Lack of transportation can lead to sedentary lifestyles, as well as not being able to travel to grocery stores with affordable prices or education programs that are not within walking distance.• Lower education level• Poverty related to food insecurity. Food insecurity can lead to maladaptive eating patterns and coping strategies that contribute to the “hunger-obesity” paradox• Access to the Internet for information.Promote healthful home environments using an interdisciplinaryapproach. Combine nutrition and health education with strategiesused in parenting, resource and financial management education.Help mothers…• Develop family routines and rituals (e.g., eating together as a family)• Reduce stress: Connect to resources (i.e., financial assistance, emotional support, information); strengthen problem-solving skills• Strengthen resource management and financial literacy skills• Strengthen basic food preparation and meal planning skills that promote healthy eating• Identify simple strategies to help children make healthy food choices (e.g., keep healthy food choices in refrigerator and cupboards; leave fresh fruit on table vs cookies)• Identify strategies to improve their diets, eating behaviors and activity levels• Learn developmentally appropriate expectations for child eating and activity• Identify strategies to strengthen the parent/child feeding relationship• Identify strategies to help children be active (e.g., media time limits, go for family walk) 10

Relationship between the home environment’s risk for child obesity and family well being among rural low income families

by Marissa Stone

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